(Page updated at 2021-11-01 09:50:15)
Data from:
* COVID Link breakthrough cases data by MDH, as of 10.29.21
* COVID Link VOC/VOI data by MDH, as of 10.29.21
* The number of total new COVID-19 cases by MDH, as of 2021-11-01.
* Vaccination data from Immunet, as of 10292021.
* COVID19 hospitalization data by MDH, as of 10.29.21.
See Annex for detailed note about the data.
A total of 42154 COVID-19 breakthrough cases have been identified in Maryland. In Harford county, 2217 cases have been reported. Below figure shows the daily number of breakthrough cases over time.
(NOTE: the 7-day average is the mean during a week leading to the date.)
To date, among people who have been fully vaccinated in the county (n=150746), 1.47% have had a breakthrough case - assuming no multiple breakthrough cases per person.
Following figure shows cumulative percent of fully vaccinated people who have breakthrough cases. We expect the cumulative percent to:
- fluctuate initially, depending on the pace of numerator increase (number of breakthrough cases - see above figure) vs. pace of denominator increase (number of people fully vaccinated), and then
- level-off, based on expected vaccine effectiveness.
(Rate using person years forthcoming… )
(Note: percent = 100* ‘# cum cases on day X’ / ‘# cum fully vaccinated people on day X-14’)
Note:
* Non breakthrough cases = total cases - breakthrough cases. This assumes date in total cases is based specimens collection date, which was used in breakthrough case data. This may not be correct, but the implication is minor as long as there is only minimal report delay.
* Fully vaccinated population on day X = population who received second/final dose 14 days ago (X-14).
* Not fully vaccinated population = total population - fully vaccinated population * See detailed numerators and denominators below.
Below figure shows expected percent of breakthrough cases based on vaccine efficacy and vaccine coverage, according to Chen and Orenstein (1996). But, this method requires routine (unbiased) surveillance system…
In Harford county, 50% of breakthrough cases occurred within 150 days after receiving the second dose. 75% of breakthrough cases occurred within 188 days.
In Maryland, similarly, 50% of breakthrough cases occurred within 147 days after receiving the second dose. 75% of breakthrough cases occurred within 184 days.
But, by age group, the distribution is little different. See below.
No ID to merge immunet data and breakthrough data. need to check all COVID link reports variables.
| Group | Group.label | In the last 6 weeks: Harford county, Number | In the last 6 weeks: Harford county, % | In the last 6 weeks: MD, Number | In the last 6 weeks: MD, % | Prior to the last 6 weeks: Harford county, Number | Prior to the last 6 weeks: Harford county, % | Prior to the last 6 weeks: MD, Number | Prior to the last 6 weeks: MD, % |
|---|---|---|---|---|---|---|---|---|---|
| By Age | |||||||||
| 12-19 | 53 | 4 | 1325 | 5 | 55 | 7 | 778 | 5 | |
| 20-29 | 140 | 10 | 3629 | 14 | 91 | 11 | 1640 | 12 | |
| 30-39 | 257 | 19 | 4788 | 18 | 121 | 15 | 2449 | 17 | |
| 40-49 | 278 | 20 | 4619 | 18 | 150 | 18 | 2326 | 16 | |
| 50-59 | 231 | 17 | 4493 | 17 | 161 | 19 | 2615 | 18 | |
| 60-69 | 210 | 15 | 3926 | 15 | 143 | 17 | 2347 | 16 | |
| 70+ | 220 | 16 | 3499 | 13 | 107 | 13 | 2091 | 15 | |
| 11 and Under | 19 | 0 | 11 | 0 | |||||
| By death | |||||||||
| No | 1373 | 99 | 26059 | 99 | 825 | 100 | 14183 | 99 | |
| Yes | 16 | 1 | 239 | 1 | 3 | 0 | 74 | 1 | |
| By hospitalization | |||||||||
| No | 1388 | 100 | 26226 | 100 | 816 | 99 | 14038 | 98 | |
| Yes | 1 | 0 | 72 | 0 | 12 | 1 | 219 | 2 | |
| By Having.Symptoms | |||||||||
| missing | 148 | 11 | 2427 | 9 | 370 | 45 | 5157 | 36 | |
| No | 686 | 49 | 10441 | 40 | 33 | 4 | 999 | 7 | |
| Yes | 555 | 40 | 13430 | 51 | 425 | 51 | 8101 | 57 | |
| By Variant.Lineage | |||||||||
| Not tested | 1188 | 85.53 | 22068 | 83.92 | 806 | 97.34 | 13982 | 98.07 | |
| VOC: Alpha (UK) | 20 | 1.44 | 341 | 1.3 | |||||
| VOC: Beta (South Africa) | 10 | 0.04 | |||||||
| VOC: Delta (India) | 114 | 8.21 | 2730 | 10.38 | 12 | 1.45 | 160 | 1.12 | |
| VOC: Gamma (Japan/Brazil) | 19 | 0.07 | |||||||
| VOI: Eta | 7 | 0.03 | |||||||
| VOI: Iota (US/NY) | 5 | 0.36 | 49 | 0.19 | |||||
| Wild Type | 11 | 0.79 | 145 | 0.55 | |||||
| NA | 51 | 3.67 | 929 | 3.53 | 10 | 1.21 | 115 | 0.81 | |
| By Congregate.Housing | |||||||||
| 0 | 1351 | 97 | 25809 | 98 | 820 | 99 | 14004 | 98 | |
| 1 | 38 | 3 | 489 | 2 | 8 | 1 | 253 | 2 |
Work in progress using Redcap/Prepmod data
NEDSS is unique in redcap data.
NEDSS is NOT unique in hospitalization data…
Work in progress. YJ to double check ID variables in COVIDlink reports…
The list of VOC and VOI updated as of September 17, 2021.
Variants of concern: https://www.cdc.gov/coronavirus/2019-ncov/variants/variant-info.html#Concern
* B.1.1.7 (Alpha),
* B.1.351 (Beta),
* B.1.617.2 + AY… (Delta),
* P.1 (Gamma)
Variants of interest: https://www.cdc.gov/coronavirus/2019-ncov/variants/variant-info.html#Interest
* B.1.525 (Eta),
* B.1.526 (Iota),
* B.1.617.1 (Kappa), and
* B.1.617.3 (No name - 20A)
See Annex regarding further information on variant testing in Maryland.
NOTE: there is a substantial delay in getting the variants data, potentially up to a month
Below figures are weekly trends for Harford county, based on MDH’s “Weekly COVID Hospitalizations Line List”, received on 10.29.21.
###Annex Data source 1. Breakthrough cases: Reports, Cases w Vax Breakthrough (>=14 days) 4 and Cases w Vax Breakthrough (>=14 days) 3, from COVID Link (http://mdcovid.lightning.force.com/).
Breakthrough cases are identified, based on the following - according to Alex Goode at MDH:
“1. COVID-19 case is matched to the CRISP master patient index based on Firstname, Lastname, DOB, Gender, Address - pulls in something called EID - Enterprise Identifier
2. Immunet data is separately matched to the CRISP master patient index on Firstname, Lastname, DOB, Gender, Address
3. Immunet Data is added to the contact object where contact.EID = immunet.EID
4. We provide the Immunet Names and DOB to ensure the match is accurate, since there is a very small chance of mismatching, although this match is usually > 99% reliable and catches variations in name and address entry, and accommodates simple transpositions of dates of birth, etc in one of the sources - still allowing the records to match.”
Data source 2. New COVID-19 cases: from MDH (https://opendata.arcgis.com/datasets/0573e90adab5434f97b082590c503bc1_0.geojson)
Data source 3. Number of people fully vaccinated: Immunet data from MDH.
Data source 5. COVID-19 hospitalization data; updated data from MDH received on Fridays.
Data source 5. VOC/VOI cases: A “report”, Cases with VoC, from COVID Link (http://mdcovid.lightning.force.com/).
Also, see below for further information about testing for variants (source: Email communication with Monique Duwell, MDH, Chief, Center for Infectious Disease Surveillance and Outbreak Response; July 29, 2021)
"1. Can you tell us roughly what percent of COVID-19 cases are tested for variants in Maryland? Currently, and, if different, in the past as well?
Based on the sequencing results reported to our surveillance program, about 15% of COVID cases are being sequenced. This is likely an under-estimate of the true % of sequencing being performed statewide.
3.Do you know the general turnaround time for the variant test result: from specimen collection to data entry in the COVID link?
It varies greatly, largely due to the variability in amount of time it takes for labs to complete sequencing, and the amount of time it takes for them to upload the data to GISAID or report to us directly. I would say that about 3-4 weeks is the average turnaround time."